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[Non-surgical closure of patent ductus arteriosus: acute and long-term results]
T Chatterjee1, S Windecker, J P Pfammatter
1Kardiologie, Universitätsspital, Bern. tushar.chatterjee@insel.ch
Insights
Transcatheter closure of a patent ductus arteriosus (PDA) is a safe and effective treatment. This minimally invasive procedure demonstrated high closure rates in both adults and children, with no major complications observed.
Area of Science:
- Cardiology
- Interventional Cardiology
- Pediatric Cardiology
Context:
- Patent ductus arteriosus (PDA) closure is recommended due to risks of endocarditis, heart failure, and pulmonary hypertension.
- Asymptomatic patients with small shunts also benefit from PDA closure.
- Transcatheter closure offers a less invasive alternative to surgical intervention.
Purpose:
- To evaluate the safety and efficacy of transcatheter closure for patent ductus arteriosus (PDA).
- To assess immediate and long-term closure rates using various devices.
- To report complication rates associated with the procedure.
Summary:
- 16 patients underwent transcatheter PDA closure using devices like the Rashkind umbrella and Amplatzer duct occluder.
- Immediate complete closure was achieved in 56% of patients, rising to 87% at a mean 19-month follow-up.
- Adults achieved 100% closure, while children had a 71% closure rate, with no device embolisms or endarteritis.
Impact:
- Transcatheter PDA closure is a safe and effective treatment option.
- The procedure offers high success rates with minimal complications.
- This technique provides a viable alternative for managing PDA in both pediatric and adult populations.
Introduction:
Closure of a patent ductus arteriosus (PDA) even with small shunt volumes in asymptomatic patients is recommended because of the risk of endocarditis (1.5% per year) and the potential development of congestive heart failure or pulmonary hypertension.
Methods:
16 patients (9 adults [5 men/4 women] and 7 children [3 boys/4 girls]) underwent transcatheter closure of a PDA. The intervention was performed using the Rashkind umbrella in 12 cases, the Amplatzer duct occluder in 2 cases, a coil in 2 cases, and the Sideris self-adjusting device in one case. Echocardiographic controls were carried out one day, 6 months, 12 months and 24 months after the intervention.
Results:
PDA closure was complete immediately following the intervention in 9 of 16 patients (56%). At follow-up (mean 19 months) complete closure was observed in 14 of 16 patients (87%). All residual shunts were trivial. The complete closure rate in adults was 100% and in children 71%. Complications such as device embolism, endarteritis and haemolysis did not occur.
Conclusion:
Non-surgical closure of a PDA is a safe and effective technique.